[Application of the subjective and objective evaluation in functional rhinoplasty]

Objective: To explore the subjective and objective evaluation methods in functional rhinoplasty. Methods: Sixty-four patients who underwent rhinoplasty in the Department of Otorhinolaryngology, the First Affiliated Hospital of Chongqing Medical University were included in this study from January 2017 to October 2018. There were 32 males and 32 females, with the age ranging from 18 to 45 years old. Before and 6 months after operation, nasal ventilation function was evaluated by Visual Analogue Scale (VAS), Nasal Obstruction Symptom Evaluation (NOSE), nasal acoustic reflex and nasal resistance. Satisfaction with nasal appearance was evaluated by VAS, Rhinoplasty Outcome Evaluation (ROE) and facial proportions evaluation. Psychological state was assessed by Emotional Balance Scale and Rosenberg Self-esteem Scale. Finally, the Pearson correlation analysis of patient satisfaction was performed. SPSS 23.0 software was used for statistical analysis. Results: Compared with pre-operation, nasal obstruction VAS, NOSE scores, total nasal resistance and difference ratio of nasal resistance showed significantly decline after surgery (1.62±0.85 vs 7.56±1.44, 22.62±3.54 vs 69.75±7.85, (0.16±0.08) Pa·s/ml vs (0.31±0.43) Pa·s/ml, 0.33±0.28 vs 0.71±0.32, all P<0.05). VAS of appearance and ROE scores showed an increase after surgery (11.20±3.66 vs 2.70±0.97, 17.80±2.71 vs 7.50±1.12, all P<0.05). The measurement of the external nasal subunits showed that the length of the dorsum of the nose, the angle of the face to the nose, the angle of the frontal and the angle of the alar of the nose were obviously reduced ((29.33±4.26) mm vs (33.61±5.24) mm, (135.11±3.81)° vs (139.91±6.30)°, (130.63±2.88)° vs (136.74±5.72)°, (99.71±4.02)° vs (106.27±5.60)°, all P<0.05). The scores of postoperative Emotional Balance Scale and Rosenberg Self-esteem Scale increased significantly (5.88±1.54 vs 4.31±1.85, 28.31±2.64 vs 22.13±2.77, all P<0.05). The Pearson correlation analysis showed that patients' satisfaction was positively correlated with subjective score of nasal ventilation (VAS, NOSE), subjective score of nasal appearance (VAS, ROE) and emotional balance scale, while negatively correlated with nasal resistance, and not correlated with the measurement of external nasal subunit. There was a significant positive correlation between the subjective score of nasal ventilation and the measurement of nasal resistance, but there was no significant correlation between the subjective score of nasal appearance and the measurement of external nasal subunit. Conclusion: The subjective and objective evaluation of nasal ventilation function, aesthetics of nasal appearance and psychological state can evaluate the effect of functional rhinoplasty effectively.

Reduced miR-363-3p expression in non-small cell lung cancer is associated with gemcitabine resistance via targeting of CUL4A

OBJECTIVE

Accumulating evidence has suggested that aberrant expression of microRNAs (miRNAs) is associated with non-small cell lung cancer (NSCLC) proliferation, migration, invasion and chemotherapy resistance. Cullin4A (CUL4A) has been previously reported to desensitize NSCLC cells to chemotherapy treatment. However, whether miRNAs regulate CUL4A to promote chemotherapy resistance remains unknown.

PATIENTS AND METHODS

Tissues were obtained from 40 NSCLC patients who received surgery at the Yancheng City No. 1 People's Hospital. Cell Counting Kit-8 (CCK-8) assays were applied for the detection of cell proliferation; mRNA and protein levels were determined by Real Time-quantitative Polymerase Chain Reaction (RT-qPCR) and Western blot, respectively. The interaction between mRNA 3'UTR and miRNA was predicted by TargetScan and verified by Dual-Luciferase reporter assay.

RESULTS

In the present study, miR-363-3p levels were revealed to be significantly decreased in tumor tissues obtained from NSCLC patients compared with adjacent normal tissues. The results of the CCK-8 assays showed that the overexpression of miR-363-3p may slightly inhibit the proliferation of A549 and H23 cells. Notably, the transfection with miR-363-3p antagonists reduced the sensitivity of A549 and H23 cells to gemcitabine treatment, whereas the overexpression of miR-363-3p markedly increased the sensitivity of A549 and H23 cells to gemcitabine treatment. Furthermore, CUL4A mRNA and protein levels were revealed to be decreased in A549 cells transfected with miR-363-3p mimics. The Dual-Luciferase reporter assay results further suggested that CUL4A represents a target gene of miR-363-3p.

CONCLUSIONS

The results indicated that decreased miR-363-3p expression enhanced gemcitabine resistance in NSCLC cells via regulation of CUL4A.

ORE identifies extreme expression effects enriched for rare variants

MOTIVATION

Non-coding rare variants (RVs) may contribute to Mendelian disorders but have been challenging to study due to small sample sizes, genetic heterogeneity and uncertainty about relevant non-coding features. Previous studies identified RVs associated with expression outliers, but varying outlier definitions were employed and no comprehensive open-source software was developed.

RESULTS

We developed Outlier-RV Enrichment (ORE) to identify biologically-meaningful non-coding RVs. We implemented ORE combining whole-genome sequencing and cardiac RNAseq from congenital heart defect patients from the Pediatric Cardiac Genomics Consortium and deceased adults from Genotype-Tissue Expression. Use of rank-based outliers maximized sensitivity while a most extreme outlier approach maximized specificity. Rarer variants had stronger associations, suggesting they are under negative selective pressure and providing a basis for investigating their contribution to Mendelian disorders.

AVAILABILITY AND IMPLEMENTATION

ORE, source code, and documentation are available at https://pypi.python.org/pypi/ore under the MIT license.

SUPPLEMENTARY INFORMATION

Supplementary data are available at Bioinformatics online.

[Association between serum levels of osteopontin and systolic pulmonary artery pressure among healthy adults post acute high altitude exposure]

Objective: To explore the association between serum levels of osteopontin (OPN) and systolic pulmonary artery pressure (sPAP) in healthy men following acute high altitude exposure. Methods: According to the inclusion and exclusion criteria, this observational study included 94 male subjects (aged from 18 to 30 years, dwelling in lowland<500 m) who ascended to Litang (4 100 m) from Chongqing (400 m) by bus with a stair-like journey within 7 days in June 2013. Data including basic information, OPN, superoxide dismutase (SOD), and malondialdehyde (MDA) and echocardiographic derived sPAP were collected within 48 hours before ascent and within 2-7 hours after arrival. Accordingly, subjects were divided into 3 groups based on the tertiles of sPAP after acute high altitude exposure: low sPAP group (26.8-32.3 mmHg (1 mmHg=0.133 kPa)) (n=31), middle sPAP group (32.4-37.4 mmHg) (n=32) and high sPAP group (37.5-55.6 mmHg) (n=31). Associations of serum OPN and SOD levels with sPAP were analysed by univariate and multivariate linear regression analysis. Results: After acute high altitude exposure, the levels of sPAP were significantly increased (P<0.001). There were no differences in age, height, weight, body mass index, percent of Han nationality and smoking among 3 subgroups. However, following acute high altitude exposure, the levels of heart rate, systolic and diastolic blood pressure elevated (all P<0.05), whereas the levels of oxygen saturation were reduced in the total subjects and all subgroups (all P<0.05). Moreover, systolic blood pressure of subjects in the high sPAP group was higher than that in low and middle sPAP groups (both P<0.05), and diastolic blood pressure of subjects in high sPAP group was higher than that in low sPAP group (P<0.05). The serum levels of OPN were increased in total cohort(27.9 (22.5,34.0) μg/L vs. 25.6 (18.4, 33.1) μg/L, P<0.05)， and high sPAP group (P<0.05), whereas no differences were found in serum SOD and MDA levels among groups. Furthermore, the serum level of OPN in high sPAP group was higher than that in low sPAP group at high altitude (P<0.05), and there was a trend for decline in SOD level with increasing sPAP (P>0.05). Results from univariable linear regression analysis showed that the serum levels of OPN (r=0.32, P=0.002) and SOD (r=-0.22，P=0.032) were linearly correlated with sPAP in total cohort after high altitude exposure. Multivariate regression analysis showed that the serum levels of OPN(β=0.310，P=0.002) and SOD (β=-0.199，P=0.043) were independently associated with the levels of sPAP at high altitude. Conclusion: After acute high altitude exposure, the serum level of OPN is positively associated with sPAP, suggesting that OPN may be a novel bio-marker for predicting the increase of pulmonary pressure in response to acute high altitude exposure.

Risk factors for disease progression in patients with mild to moderate coronavirus disease 2019-a multi-centre observational study

Objectives

Since December 2019, the novel coronavirus disease 2019 (COVID-19) that emerged in Wuhan city has spread rapidly around the world. The risk for poor outcome dramatically increases once a patient progresses to the severe or critical stage. The present study aims to investigate the risk factors for disease progression in individuals with mild to moderate COVID-19.

Methods

We conducted a cohort study that included 1007 individuals with mild to moderate COVID-19 from three hospitals in Wuhan. Clinical characteristics and baseline laboratory findings were collected. Patients were followed up for 28 days for observation of disease progression. The end point was the progression to a more severe disease stage.

Results

During a follow up of 28 days, 720 patients (71.50%) had recovered or were symptomatically stable, 222 patients (22.05%) had progressed to severe disease, 22 patients (2.18%) had progressed to the critically ill stage and 43 patients (4.27%) had died. Multivariate Cox proportional hazards models identified that increased age (hazard ratio (HR) 2.56, 95% CI 1.97–3.33), male sex (HR 1.79, 95% CI 1.41–2.28), presence of hypertension (HR 1.44, 95% CI 1.11–1.88), diabetes (HR 1.82, 95% CI 1.35–2.44), chronic obstructive pulmonary disease (HR 2.01, 95% CI 1.38–2.93) and coronary artery disease (HR 1.83, 95% CI 1.26–2.66) were risk factors for disease progression. History of smoking was protective against disease progression (HR 0.56, 95% CI 0.34–0.91). Elevated procalcitonin (HR 1.72, 95% CI 1.02–2.90), urea nitrogen (HR 1.72, 95% CI 1.21–2.43), α-hydroxybutyrate dehydrogenase (HR 3.02, 95% CI 1.26–7.21) and D-dimer (HR 2.01, 95% CI 1.12–3.58) at baseline were also associated with risk for disease progression.

Conclusions

This study identified a panel of risk factors for disease progression in individuals with mild to moderate COVID-19.

Measurement of the Lund Jet Plane Using Charged Particles in 13 TeV Proton-Proton Collisions with the ATLAS Detector

The prevalence of hadronic jets at the LHC requires that a deep understanding of jet formation and structure is achieved in order to reach the highest levels of experimental and theoretical precision. There have been many measurements of jet substructure at the LHC and previous colliders, but the targeted observables mix physical effects from various origins. Based on a recent proposal to factorize physical effects, this Letter presents a double-differential cross-section measurement of the Lund jet plane using 139  fb^{-1} of sqrt[s]=13  TeV proton-proton collision data collected with the ATLAS detector using jets with transverse momentum above 675 GeV. The measurement uses charged particles to achieve a fine angular resolution and is corrected for acceptance and detector effects. Several parton shower Monte Carlo models are compared with the data. No single model is found to be in agreement with the measured data across the entire plane.

AB0610 SEASONAL VARIATION IN IDIOPATHIC INFLAMMATORY MYOPATHIES INCIDENCE AND PRESENTATION: A RETROSPECTIVE STUDY IN BEIJING AND HONG KONG

Background:

Seasonal patterns of disease onset and severity in idiopathic inflammatory myopathies (IIMs) as a whole are conflicting [1-3]. In recent years, over 10 myositis-specific antibodies (MSAs) have been identified. They are able to divide patients into homogenous subgroups and inform on prognosis [4].

Objectives:

The objective of the study was to investigate the seasonal variation of onset of IIMs characterised serologically.

Methods:

This was a multi-centred retrospective observational study. Consecutive Chinese patients with IIMs admitted to the rheumatology wards of the participating major regional hospitals in Beijing and Hong Kong from July 2013 to June 2018 were recruited. The diagnosis of IIMs was based on the Bohan and Peter’s criteria with definite or probable cases being included [5]. Patients with clinically amyopathic disease must have the typical Gottron’s papules or heliotrope rash as determined by rheumatologists or dermatologists, and with no symptoms or signs of muscle involvement according to Sontheimer [6]. Patients with juvenile myositis, inclusion body myositis, cancer-associated myositis and myositis associated with other connective tissue disease were excluded. A commercial line blot immunoassay kit (EUROLINE) was used to detect the MSAs.

Results:

All together 495 patients were studied. The mean age of the patients at disease onset was 48.1 years (S.D. 13.3). There was a female predominance (68.3%). The subgroups of IIMs were: dermatomyositis (61.0%), polymyositis (21.8%), clinically amyopathic dermatomyositis (12.9%), immune mediated necrotising myopathy (3.8%) and nonspecific myositis (0.4%). No particular seasonal pattern in disease onset was observed in IIM patients as a whole (Figure 1) or in any classical subgroups. However, significantly more patients with any one MSA had their disease started in the first half of the year (p=0.007) as shown in Figure 2. Patients with either anti-synthetase or anti-MDA5 antibodies, which are associated with interstitial lung disease, had more frequent disease onset from November to February, which might coincide with the local flu season. It was also found that MSA positivity was associated with infection of the patient (p=0.005). Further analyses showed that patients with MSAs which are typically associated with severe skin disease (MDA5, TIF1g, NXP2, SAE) had more hospitalisation from April to September where excessive sun exposure is expected. There were no major differences between the Beijing and Hong Kong subgroups.

Conclusion:

Apparent seasonal patterns were noticed in our ethno-serologically defined IIM patients. Certain environmental factors, particularly infection or UV exposure, could be potential triggers. Our findings could shed light on the identification of etiologic factors and enhance our understanding of disease pathogenesis.

References:

[1]Manta P, Kalfakis N, Vassilopoulos D. Evidence for Seasonal Variation in Polymyositis. Neuroepidemiology 1989;8:262–265.

[2]Phillips BA, Zilko PJ, Garlepp MJ, et al. Seasonal occurrence of relapses in inflammatory myopathies: a preliminary study. J Neurol 2002;249:441–4.

[3]Lefe R, Burgess S, Miller F, et al. Distinct Seasonal Pattern in The Onset of Adult Idiopathic Inflammatory Myopathy in Patients with Auto Antibodies Anti-Jo-1 and Anti-Signal Recognition particle. Arthritis and Rheumatism 1991;34(11):1391-1396.

[4]Tansley SL, Betterridge ZE, McHugh NJ. The diagnostic utility of autoantibodies in adult and juvenile myostis. Curt Opin Rheumatol 2013;25(6):772-777.

[5]Bohan A, Peter JB. Polymyositis and dermatomyositis. N Engl J Med 1975;292:344-347.

[6]Sontheimer RD. Clinically myopathic dermatomyositis: what can we now tell our patients? Arch Dermatol 2010;146(1):76-80.

Disclosure of Interests:

None declared

Retrospective analysis of defect reconstruction after abdominal wall tumor resection in 30 patients

PURPOSE

It is difficult to manage the full-thickness defect that is created by radical resection of an abdominal wall tumor. This report aimed to review our institutional experience with immediate reconstruction using mesh reinforcement after abdominal wall tumor resection.

METHODS

We retrospectively examined patients who underwent abdominal wall tumor resection with immediate mesh-reinforced reconstruction between April 2014 and November 2018. The patients' records were reviewed to collect data regarding their demographic characteristics, surgical procedures, and complications.

RESULTS

We identified 30 eligible patients, including 5 who underwent simultaneous resection of affected intra-abdominal organs or tissues. The median size of the resulting abdominal wall defect was 60 cm² (interquartile range: 32-127.5 cm²) and the median mesh size was 150 cm² (interquartile range: 150-225 cm²). The median operative time was 85 min (interquartile range: 60-133.8 min), the mean hospital stay was 19.4 ± 9.0 days, and the mean follow-up period was 28.6 ± 16.0 months. The complications included seroma (n = 4), infection (n = 2), massive hematoma (n = 1), and abnormal sensation (n = 3). Tumor recurrence was observed in two patients, and three patients died because of cancer progression. No patient developed a ventral hernia or abdominal bulging.

CONCLUSION

Immediate mesh-reinforced reconstruction is feasible and effective for patients who require abdominal wall tumor resection.

High-Temperature Charge-Stripe Correlations in La_{1.675}Eu_{0.2}Sr_{0.125}CuO_{4}

We use resonant inelastic x-ray scattering to investigate charge-stripe correlations in La_{1.675}Eu_{0.2}Sr_{0.125}CuO_{4}. By differentiating elastic from inelastic scattering, it is demonstrated that charge-stripe correlations precede both the structural low-temperature tetragonal phase and the transport-defined pseudogap onset. The scattering peak amplitude from charge stripes decays approximately as T^{-2} towards our detection limit. The in-plane integrated intensity, however, remains roughly temperature independent. Therefore, although the incommensurability shows a remarkably large increase at high temperature, our results are interpreted via a single scattering constituent. In fact, direct comparison to other stripe-ordered compounds (La_{1.875}Ba_{0.125}CuO_{4}, La_{1.475}Nd_{0.4}Sr_{0.125}CuO_{4}, and La_{1.875}Sr_{0.125}CuO_{4}) suggests a roughly constant integrated scattering intensity across all these compounds. Our results therefore provide a unifying picture for the charge-stripe ordering in La-based cuprates. As charge correlations in La_{1.675}Eu_{0.2}Sr_{0.125}CuO_{4} extend beyond the low-temperature tetragonal and pseudogap phase, their emergence heralds a spontaneous symmetry breaking in this compound.

Genetic Diversity of Colletotrichum spp. Causing Strawberry Anthracnose in Zhejiang, China

Anthracnose is a serious fungal disease that primarily infects strawberry roots and stolons during development. Here, 91 isolates from different areas of Zhejiang province, China, were collected. Morphological characteristics were analyzed, and a phylogenetic analysis based on multiple genes (actin, internal transcribed spacer, calmodulin, glyceraldehyde-3-phosphate dehydrogenase, and chitin synthase) was performed. We found that all of the Colletotrichum species causing strawberry anthracnose belonged to the Colletotrichum gloeosporioides complex. Among them, we identified 48 isolates of C. fructicola, 21 isolates of C. siamense, 13 isolates of C. gloeosporioides, and 9 isolates of C. aenigma. C. siamense was distributed in the central and eastern regions of Zhejiang province (Hangzhou, Jinhua, Shaoxing, Ningbo, and Taizhou). This is the first report of C. siamense causing strawberry anthracnose in Zhejiang province. C. fructicola was the most dominant species causing strawberry anthracnose in Zhejiang province. We identified the four species causing strawberry anthracnose in Zhejiang province, which will improve our understanding of the strawberry anthracnose epidemic and will benefit the development of future control measures.

The CLDN5 locus may be involved in the vulnerability to schizophrenia

The present study was designed to detect three single nucleotide polymorphisms (SNPs) located on 22q11 that was thought as being of particularly importance for genetic research into schizophrenia. We recruited a total of 176 Chinese family trios of Han descent, consisting of mothers, fathers and affected offspring with schizophrenia for the genetic analysis. The transmission disequilibrium test (TDT) showed that of three SNPs, rs10314 in the 3′-untranslated region of the CLDN5 locus was associated with schizophrenia (χ2= 4.75,P= 0.029). The other two SNPs, rs1548359 present in the CDC45L locus centromeric of rs10314 and rs739371 in the 5′-flanking region of the CLDN5 locus, did not show such an association. The global chi-square (χ2) test showed that the 3-SNP haplotype system was not associated with schizophrenia although the 1-df test for individual haplotypes showed that the rs1548359(C)-rs10314(G)-rs739371(C) haplotype was excessively non-transmitted (χ2= 5.32,P= 0.02). Because the claudin proteins are a major component for barrier-forming tight junctions that could play a crucial role in response to changing natural, physiological and pathological conditions, the CLDN5 association with schizophrenia may be an important clue leading to look into a meeting point of genetic and environmental factors.

A Weak Association of the CLDN5 Locus with Schizophrenia in Chinese Case-control Samples

Background:

An increasing number of studies have described the relationship between velo-cardio-facial syndrome (VCFS) and schizophrenia. in a family-based study, we found that rs10314, a single nucleotide polymorphism (SNP) present in the 3’-flanking region of the CLDN5 gene, was associated with schizophrenia among a Chinese population. High false positive rate is a common problem with the association study of human diseases. It is very important to replicate an initial finding with different samples and experimental designs.

Methods:

A total of 749 patients with schizophrenia and 383 age and sex matched healthy control subjects in Chinese population were recruited. PCR-based RFLP protocol was applied to genotype rs10314 to see its disease association.

Results:

The χ2 goodness-of-fit test showed that the genotypic distributions of rs10314 were in Hardy-Weinberg equilibrium in both the patient group (χ2=1.12, P=0.289) and the control group (χ2=0.22, P=0.639). rs10314 was associated with schizophrenia with an odds ratio (OR) of 1.32 in the male subjects (χ2=5.45, P=0.02, 95% CI 1.05-1.67) but not in the female subjects (χ2=0.64, P=0.425, OR=1.14, 95% CI 0.83-1.57). the χ2 test showed a genotypic association only for combined samples (χ2=7.80, df=2, P=0.02). SNP rs10314 is a G to C base change. Frequency of the genotypes containing the C allele was significantly higher in the patient group than in the control group.

Conclusions:

The present work shows that the CLDN5 gene polymorphism is more likely to be involved in schizophrenic men than women, suggesting that this gene may contribute to the gender differences in schizophrenia.

Mini-mesh and Lichtenstein repair compared with a modified Kugel technique for femoral hernia: a randomised controlled trial

INTRODUCTION

A modified Kugel patch is more expensive than ordinary mesh and demands a wide dissection of the preperitoneal space in femoral hernia repair. We therefore adopted a novel method using mini-mesh and a Lichtenstein repair. This study compared mini-mesh and Lichtenstein repair with a modified Kugel technique in patients with a primary unilateral femoral hernia.

METHODS

Patients with unilateral femoral hernia were assigned randomly to undergo mini-mesh and Lichtenstein repair (M group) or modified Kugel repair (K group), followed-up at one week, three months, one year and two years. Demographics, hernia characteristics and operative outcomes of two groups were analysed.

RESULTS

A total of 48 patients in the K group and 49 participants in the M group completed follow-up. The operation time for the M group (68.6 ± 13.4 minutes) was significantly shorter than that of the K group (80.6 ± 10.1 minutes; p=0.030). There was no significant difference between the two groups for chronic pain, foreign body feeling and quality of life, and no recurrence occurred.

CONCLUSIONS

Mini-mesh and Lichtenstein repairs have reasonable results in the patients with femoral hernia in this study, with a reduced operation time compared with a modified Kugel repair. The trial was registered with the Chinese Clinical Trials Registry: ChiCTR1900022264.

Evaluation of synuclein-γ levels by novel monoclonal antibody in saliva and cancer tissues from oral squamous cell carcinoma patients

The clinical value of synuclein-γ (SNCG) in oral squamous cell carcinoma (OSCC) was evaluated by detecting the expression of SNCG in saliva and tissues and its correlation with clinicopathological parameters (age, gender, ethnicity, degree of differentiation, clinical stage, and lymph node metastasis). Salivary samples were collected from 79 patients with OSCC, 31 patients with oral premalignant lesions (OPMLs), such as oral lichen planus, oral leukoplakia, and erythema, and 80 controls, and levels of SNCG in salivary samples were determined by enzyme-linked immunosorbent assay (ELISA). Tissue expression in formalin-fixed tissue biopsies of 94 cases of OSCC and 30 adjacent normal tissues was analyzed by immunohistochemistry (IHC) using an antibody against SNCG. The results showed that the salivary levels of SNCG in patients with OSCC and OPMLs were significantly higher than those detected in the control group (p<0.001). The immunohistochemical results showed that SNCG was highly expressed in tumor cells of OSCC patients, with low expression in the adjacent normal epithelium (p<0.001, OR=6.074). Salivary SNCG level correlated with differentiation (p=0.022). Besides, the expression of SNCG in OSCC tissues was also significantly associated with differentiation (p<0.001).

Safety, feasibility, and effect of an enhanced nutritional support pathway including extended preoperative and home enteral nutrition in patients undergoing enhanced recovery after esophagectomy: a pilot randomized clinical trial

The aims of this pilot study are to evaluate the feasibility, safety, and effectiveness of conducting an enhanced nutritional support pathway including extended preoperative nutritional support and one month home enteral nutrition (HEN) for patients who underwent enhanced recovery after esophagectomy. We implemented extended preoperative nutritional support and one month HEN after discharge for patients randomized into an enhanced nutrition group and implemented standard nutritional support for patients randomized into a conventional nutrition group. Except the nutritional support program, both group patients underwent the same standardized enhanced recovery after surgery programs of esophagectomy based on published guidelines. Patients were assessed at preoperative day, postoperative day 7 (POD7), and POD30 for perioperative outcomes and nutritional status. To facilitate the determination of an effect size for subsequent appropriately powered randomized clinical trials and assess the effectiveness, the primary outcome we chose was the weight change before and after esophagectomy. Other outcomes including body mass index (BMI), lean body mass (LBM), appendicular skeletal muscle mass index (ASMI), nutrition-related complications, and quality of life (QoL) were also analyzed. The intention-to-treat analysis of the 50 randomized patients showed that there was no significant difference in baseline characteristics. The weight (-2.03 ± 2.28 kg vs. -4.05 ± 3.13 kg, P = 0.012), BMI (-0.73 ± 0.79 kg/m2 vs. -1.48 ± 1.11 kg/m2, P = 0.008), and ASMI (-1.10 ± 0.37 kg/m2 vs. -1.60 ± 0.66 kg/m2, P = 0.010) loss of patients in the enhanced nutrition group were obviously decreased compared to the conventional nutrition group at POD30. In particular, LBM (48.90 ± 9.69 kg vs. 41.96 ± 9.37 kg, p = 0.031) and ASMI (7.56 ± 1.07 kg/m2 vs. 6.50 ± 0.97 kg/m2, P = 0.003) in the enhanced nutrition group were significantly higher compared to the conventional nutrition group at POD30, despite no significant change between pre- and postoperation. In addition, European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 scores revealed that enhanced nutritional support improved the QoL of patients in physical function (75.13 ± 9.72 vs. 68.33 ± 7.68, P = 0.009) and fatigue symptom (42.27 ± 9.93 vs. 49.07 ± 11.33, P = 0.028) compared to conventional nutritional support. This pilot study demonstrated that an enhanced nutritional support pathway including extended preoperative nutritional support and HEN was feasible, safe, and might be beneficial to patients who underwent enhanced recovery after esophagectomy. An appropriately powered trial is warranted to confirm the efficacy of this approach.

Palmatine alleviates hyperalgesia by inhibiting the expression of calcitonin gene-related peptide in the trigeminal ganglion of rats with chronic constriction injury of the infraorbital nerve

Trigeminal neuralgia is one of the most common of the neuropathic pains, and it can seriously influence patients' quality of life. Calcitonin gene-related peptide (CGRP) is a type of nociceptive neurotransmitter that is expressed in neurons of the trigeminal ganglion and plays a major part in transmitting pain. The rat model of trigeminal neuralgia was established by causing a chronic constriction injury of the infraorbital nerve (CCI-ION). Male Sprague-Dawley rats (n=24) were randomly divided into a sham control group (sham, n=6), sham-treated with palmatine group (sham+palmatine, n=6), trigeminal nerve model group (TN, n=6), and trigeminal nerve treated with palmatine group (TN+palmatine, n=6). Fifteen days after the operation the mechanical response threshold was decreased in the TN group compared with the sham group. From postoperative day 7 to day 15, the mechanical response threshold in the TN+palmatine group significantly increased compared with the TN group. On postoperative day 15 the results of quantitative polymerase chain reaction (qPCR), immunohistochemical staining, and western blotting showed an obvious increase in expression of CGRP and its receptors, serum concentrations of interleukin-1β (IL-1β), and tumour necrosis factor-α (TNF-α), and phosphorylation of protein kinase C (PKC) in the trigeminal ganglia of the TN group compared with the sham group, but these increases could be down-regulated by treatment with palmatine. Palmatine might therefore have therapeutic potential for the treatment of trigeminal neuralgia by inhibiting the expression of CGRP and its receptors in trigeminal ganglia, suppressing the serum concentrations of IL-1β and TNF-α, and decreasing the phosphorylation of PKC in the trigeminal ganglia of affected rats.

Measurement of Azimuthal Anisotropy of Muons from Charm and Bottom Hadrons in pp Collisions at sqrt[s]=13 TeV with the ATLAS Detector

The elliptic flow of muons from the decay of charm and bottom hadrons is measured in pp collisions at sqrt[s]=13  TeV using a data sample with an integrated luminosity of 150  pb^{-1} recorded by the ATLAS detector at the LHC. The muons from heavy-flavor decay are separated from light-hadron decay muons using momentum imbalance between the tracking and muon spectrometers. The heavy-flavor decay muons are further separated into those from charm decay and those from bottom decay using the distance-of-closest-approach to the collision vertex. The measurement is performed for muons in the transverse momentum range 4-7 GeV and pseudorapidity range |η|<2.4. A significant nonzero elliptic anisotropy coefficient v_{2} is observed for muons from charm decays, while the v_{2} value for muons from bottom decays is consistent with zero within uncertainties.

[Effectiveness evaluation of health belief model-based health education intervention for patients with hypertension in community settings]

Objective: To evaluate the effectiveness of health belief model-based health education intervention in improving blood pressure control of patients with hypertension in community settings. Methods: From September 2016 to September 2017, 400 newly diagnosed patients with hypertension were recruited from 6 community healthcare centers with comparable population size and health services in the Shunyi District of Beijing. All community healthcare centers were randomly assigned to the intervention group (206 patients) and the control group (194 patients). Patients in the intervention group received 3 lectures (20-30 min for each) of health belief model-based health education. Patients in the control group received usual care. The basic characteristics, health beliefs, and health literacy were collected, and blood pressure was measured before and after the intervention, respectively. The difference-in-difference model was used to analyze the change of blood pressure and the influencing factors between two groups before and after the intervention. Results: A total of 134 patients in the intervention group and 129 patients in the control group completed the study. After adjusting for the age, gender, family income, medical insurance, chronic diseases and family history, the score of perceived barriers was increased by 1.65 (P=0.016), and perceived seriousness was decreased by 0.73 (P=0.018). The systolic blood pressure of patients was decreased by 7.37 mmHg (1 mmHg=0.133 kPa, P=0.001) and diastolic blood pressure was decreased by 4.07 mmHg (P=0.014), respectively. The β (95%CI) values were -7.37 (-11.88,-2.86) and -4.07 (-7.30, -0.84). The perceived susceptibility and self-efficacy had a significant influence on the blood pressure of patients (P<0.05). Conclusion: Health belief model-based health education intervention could significantly improve the blood pressure control of patients with hypertension in the community settings.

Laparoscopic evaluation and management of 47 patients with late-onset mesh infection after inguinal hernioplasty

INTRODUCTION

Mesh infection after inguinal hernioplasty can be complicated especially when it is caused by chronic fistula. Explantation of the infected mesh is inevitable when conservative treatment fails and is considered to be the key step toward development of future therapies. Our purpose was to determine the results of laparoscopic exploration and summarize the treatment experience of the late-onset mesh infection.

METHODS

We analyzed 47 patients with late-onset mesh infection treated at our hernia center. The medical records of these patients were retrospectively reviewed, and information regarding presentation, approach of previous hernia repair, type of mesh, operative findings, bacteriological examination result, and postoperative complications were obtained. All of the patients underwent laparoscopic exploration to identify the abscess and fistula, further debridement and treatment was performed afterwards according to the exploration results.

RESULTS

All the operative courses were uneventful. Laparoscopy revealed four intestinal fistula and one bladder fistula. Four cases of all underwent debridement and drainage using laparoscopic approach only, and the others were converted to open surgery after laparoscopic exploration to remove the infected mesh. There were two hernia recurrence and nine wound infection during the follow-up period; all the patients had an eventually recovery.

CONCLUSIONS

Laparoscopic exploration is an effective and minimally invasive method for managing the late-onset infection which can identify whether internal organ was involved and consult for the further treatment. The approach of mesh removal should be tailored according to the exploration results.

Translational outcomes in a full gene deletion of ubiquitin protein ligase E3A rat model of Angelman syndrome

Angelman syndrome (AS) is a rare neurodevelopmental disorder characterized by developmental delay, impaired communication, motor deficits and ataxia, intellectual disabilities, microcephaly, and seizures. The genetic cause of AS is the loss of expression of UBE3A (ubiquitin protein ligase E6-AP) in the brain, typically due to a deletion of the maternal 15q11-q13 region. Previous studies have been performed using a mouse model with a deletion of a single exon of Ube3a. Since three splice variants of Ube3a exist, this has led to a lack of consistent reports and the theory that perhaps not all mouse studies were assessing the effects of an absence of all functional UBE3A. Herein, we report the generation and functional characterization of a novel model of Angelman syndrome by deleting the entire Ube3a gene in the rat. We validated that this resulted in the first comprehensive gene deletion rodent model. Ultrasonic vocalizations from newborn Ube3am-/p+ were reduced in the maternal inherited deletion group with no observable change in the Ube3am+/p- paternal transmission cohort. We also discovered Ube3am-/p+ exhibited delayed reflex development, motor deficits in rearing and fine motor skills, aberrant social communication, and impaired touchscreen learning and memory in young adults. These behavioral deficits were large in effect size and easily apparent in the larger rodent species. Low social communication was detected using a playback task that is unique to rats. Structural imaging illustrated decreased brain volume in Ube3am-/p+ and a variety of intriguing neuroanatomical phenotypes while Ube3am+/p- did not exhibit altered neuroanatomy. Our report identifies, for the first time, unique AS relevant functional phenotypes and anatomical markers as preclinical outcomes to test various strategies for gene and molecular therapies in AS.

Search for Magnetic Monopoles and Stable High-Electric-Charge Objects in 13 Tev Proton-Proton Collisions with the ATLAS Detector

A search for magnetic monopoles and high-electric-charge objects is presented using 34.4  fb^{-1} of 13 TeV pp collision data collected by the ATLAS detector at the LHC during 2015 and 2016. The considered signature is based upon high ionization in the transition radiation tracker of the inner detector associated with a pencil-shape energy deposit in the electromagnetic calorimeter. The data were collected by a dedicated trigger based on the tracker high-threshold hit capability. The results are interpreted in models of Drell-Yan pair production of stable particles with two spin hypotheses (0 and 1/2) and masses ranging from 200 to 4000 GeV. The search improves by approximately a factor of 5 the constraints on the direct production of magnetic monopoles carrying one or two Dirac magnetic charges and stable objects with electric charge in the range 20≤|z|≤60 and extends the charge range to 60<|z|≤100.

Modulating the Biofunctionality of Metal-Organic-Framework-Encapsulated Enzymes through Controllable Embedding Patterns

Embedding an enzyme within a MOF as exoskeleton (enzyme@MOF) offers new opportunities to improve the inherent fragile nature of the enzyme, but also to impart novel biofunctionality to the MOF. Despite the remarkable stability achieved for MOF-embedded enzymes, embedding patterns and conversion of the enzymatic biofunctionality after entrapment by a MOF have only received limited attention. Herein, we reveal how embedding patterns affect the bioactivity of an enzyme encapsulated in ZIF-8. The enzyme@MOF can maintain high activity when the encapsulation process is driven by rapid enzyme-triggered nucleation of ZIF-8. When the encapsulation is driven by slow coprecipitation and the enzymes are not involved in the nucleation of ZIF-8, enzyme@MOF tends to be inactive owing to unfolding and competing coordination caused by the ligand, 2-methyl imidazole. These two embedding patterns can easily be controlled by chemical modification of the amino acids of the enzymes, modulating their biofunctionality.

Low pretreatment PNI correlates with worse survival in patients with stage III/IV NSCLC who received chemotherapy

The aim of this study was to investigate the prognostic value of the prognostic nutritional index (PNI) on the long-term survival of non-small cell lung cancer (NSCLC) patients who received platinum-based chemotherapy. Data on nutritional parameters and clinicopathological characteristics [e.g., albumin, total protein, body mass index (BMI), eastern cooperative oncology group (ECOG) performance status, stage, pathology, treatment strategy] were analyzed and retrospectively correlated with overall survival (OS). The PNI was calculated based on the concentration of albumin and lymphocyte count [10 × albumin, (g/dl) + 0.005 × lymphocyte (count/mm3)]. A receiver operating characteristic curve (ROC) analysis was used to find the optimal cut-off value of PNI. Univariate and multivariate analyses were used to evaluate the prognostic value of PNI. A total of 186 patients met the inclusion criteria. The optimal cut-off value for PNI was 50.45. Compared with the parameters of the low PNI group (n=76), high PNI was significantly associated with adenocarcinoma type, stage III, better ECOG and comprehensive treatment modality. The univariate analysis demonstrated that OS was superior when PNI ≥50.45, albumin ≥35 g/l, platelet-lymphocyte ratio (PLR) ≥163 and ECOG <2, and when the patient received a comprehensive treatment modality. In the multivariate analysis, PNI, TNM stage and treatment strategy were identified as independent predictors of survival in this study. This retrospective study demonstrated that a low PNI was related to worse overall survival in patients with stage III/IV NSCLC who received platinum-based chemotherapy. These data provided a conceptual basis for further research on the clinical application of the PNI index for patients receiving chemotherapy for intermediate- and advanced-stage NSCLC.

Expressions of VEGF and miR-21 in tumor tissues of cervical cancer patients with HPV infection and their relationships with prognosis

OBJECTIVE

To investigate the expressions of vascular endothelial growth factor (VEGF) and micro-ribonucleic acid-21 (miR-21) in cervical cancer patients with human papillomavirus (HPV) infection and determine the potential relationships with prognosis.

PATIENTS AND METHODS

Expressions of VEGF in cervical cancer tissues and cancer-adjacent tissues were detected by immunohistochemistry, and the expressions of miR-21 and VEGF in both tissues were quantitatively analyzed using reverse transcription polymerase chain reaction (RT-PCR). Patients with cervical cancer were followed up after operation, and the survival rates of patients with different expression levels of miR-21 and VEGF were compared.

RESULTS

VEGF was expressed in both cervical cancer tissues and cancer-adjacent tissues. The positive expression rate of VEGF in cervical cancer tissues (75.69%) was significantly higher than that in cancer-adjacent tissues (10.45%). RT-PCR results showed that the expression levels of miR-21 and VEGF in cervical cancer tissues were significantly higher than those in cancer-adjacent tissues (p<0.05). Correlation analyses revealed that miR-21 expression was significantly positively correlated with VEGF expression in cervical cancer tissues (r2=0.4174, p<0.0001). Prognostic analyses showed that the 5-year survival rate of patients was relatively high when miR-21 and VEGF were lowly expressed.

CONCLUSIONS

VEGF and miR-21 are highly expressed in tumor tissues of cervical cancer patients with HPV infection. VEGF expression is significantly positively correlated with miR-21 expression, and the high levels of VEGF and miR-21 predict unfavorable prognosis of cervical cancer. Data provide a theoretical support for clinical treatment of cervical cancer patients with HPV infection.

Research on values of GDF-15 level in the diagnosis of primary liver cancer and evaluation of chemotherapeutic effect

OBJECTIVE

To investigate the values of growth differentiation factor-15 (GDF-15) level in the diagnosis of primary liver cancer and evaluation of chemotherapeutic effect.

PATIENTS AND METHODS

92 patients with liver cancer treated from June 2015 to May 2016 were selected as liver cancer group; 53 patients with benign liver lesion were selected as benign liver disease group, and 40 healthy subjects receiving physical examination were selected as healthy control group. Fasting venous blood was drawn from objects of study in the early morning at 1 d after admission and at the last day after chemotherapy (liver cancer group), and the serum GDF-15 level was measured.

RESULTS

The serum GDF-15 levels in patients in liver cancer group and benign liver disease group were significantly higher than those in healthy control group and benign liver disease group (p<0.05). The serum GDF-15 levels in patients with stage III and IV liver cancer were significantly higher than those in patients with stage I and II liver cancer, and the serum GDF-15 level in patients with stage IV liver cancer was significantly higher than that in patients with stage III liver cancer (p<0.05). There was no significant difference in serum GDF-15 level among patients with different clinical data (p>0.05). The ROC curve analysis showed that the threshold value of GDF-15 was 1573.23 ng/L, and the sensitivity, specificity, and accuracy were 81.23%, 83.99%, and 83.62%, respectively. The serum GDF-15 level in patients with progressive disease was significantly higher than those in patients with partial remission and stable disease, and the serum GDF-15 level in patients with stable disease was significantly higher than that in patients with partial remission (p<0.05).

CONCLUSIONS

The serum GDF-15 level has certain clinical values in the diagnosis of primary liver cancer and evaluation of chemotherapeutic effect.

Over-expressed miR-27a-3p inhibits inflammatory response to spinal cord injury by decreasing TLR4

OBJECTIVE

We investigate whether microRNA-27a-3p (miR-27a-3p) can inhibit the inflammatory response of spinal cord injury by negatively regulating toll-like receptor 4 (TLR4).

PATIENTS AND METHODS

The quantitative Real-time polymerase chain reaction (qRT-PCR) assay was used to detect the expression of miR-27a-3p and TLR4 in serum samples from patients with spinal cord injury and in hydrogen peroxide-treated C8-B4 and C8-D1A cells. Dual luciferase reporter assays were used to detect targeted binding of TLR4 to miR-27a-3p. The protein expression of miR-27a-3p and TLR4 and the two inflammatory factors, tumor necrosis factor α (TNF-α) and interleukin 6 (IL-6), were all detected by Western blot.

RESULTS

TLR4 expression was elevated and miR-27a-3p was decreased in serum samples from patients with spinal cord injury and in hydrogen peroxide-treated C8-D1A and C8-B4 cells. Dual luciferase reporter assays results demonstrated that miR-27a-3p can bind to TLR4. Up-regulation of miR-27a-3p can decrease the expression of TNF-α and IL-6 and can also reduce TLR4 expression. After overexpression of TLR4, the expression of TNF-α and IL-6 were increased.

CONCLUSIONS

miR-27a-3p can inhibit the inflammatory response of spinal cord injury by negatively regulating TLR4.

LncRNA PCAT-1 regulates the proliferation, metastasis and invasion of cervical cancer cells

OBJECTIVE

To investigate the effects of long non-coding RNA (lncRNA) PCAT-1 on the proliferation, metastasis, and invasion of cervical cancer cells.

MATERIALS AND METHODS

LncRNA PCAT-1 small interfering RNA (siRNA) and negative siRNA were transfected into cervical cancer cell lines and the expression of lncRNA PCAT-1 in cells was confirmed by Real-time quantitative polymerase chain reaction (qPCR). Cell counting kit-8 (CCK-8) and colony formation assay were applied to detect the effect of lncRNA PCAT-1 on cell proliferation. The wound-healing assay was applied to test the effect of lncRNA PCAT-1 on cell metastasis. Matrigel cell invasion assay was performed to detect the impact of lncRNA PCAT-1 expression on invasion.

RESULTS

After transfected with the long non-coding PCAT-1 siRNA into cervical cancer cell lines for 48 h, the lncRNA PCAT-1 cells were significantly down-regulated. The results of CCK-8, clonogenic and wound-healing assay showed that the decreased expression of lncRNA PCAT-1 attenuated the proliferation and metastasis of cells. The results of matrigel cell invasion assay manifested that the decreased expression of lncRNA PCAT-1 could reduce the invasion ability. The up-regulation of lncRNA PCAT-1 was associated with poor prognosis of patients with cervical cancer.

CONCLUSIONS

LncRNA PCAT-1 siRNA transfected into cervical cancer cell lines can effectively lower the expression of lncRNA PCAT-1, while lncRNA PCAT-1 expression can inhibit the proliferation, metastasis and invasion abilities of cervical cancer cells.

Renal ischemia-reperfusion injury attenuated by splenic ischemic preconditioning

OBJECTIVE

To investigate the therapeutic effect of splenic ischemic preconditioning (sIPC) on renal ischemia-reperfusion (IR) injury.

MATERIALS AND METHODS

A total of 18 adult male Sprague Dawley (SD) rats were treated by 45 min renal ischemia and followed by 24 h reperfusion. In the sIPC group, three cycles of splenic ischemic preconditioning including 5 min ischemia and 5 min reperfusion were carried out before renal ischemia. The blood samples and kidney tissues were collected after 24 h. The levels of Cr and BUN in serum were measured to evaluate the kidney function. The morphological changes in ischemia-reperfusion kidneys were determined by hematoxylin-eosin (HE) staining. The levels of pro-inflammatory cytokines including TNF-α and IL-6 in serum, and renal tissues, were measured by ELISA and Western Blotting. Furthermore, the levels of IKK-β, intra-nuclear NF-κB, p65, and IL-10 in renal tissues were also measured.

RESULTS

The results demonstrated that the level of Cr and BUN in the IR group were increased while decreased in the sIPC group. HE staining showed that the damage caused by renal ischemia-reperfusion was attenuated by sIPC with a low renal injury score in the sIPC group. ELISA and Western Blotting results showed that the production and secretion of TNF-α and IL-6 induced by IR were inhibited by sIPC. The expression level of IKK-β and intranuclear p65 in renal tissues were increased in the IR group while sIPC had exhibited the function of depressing the increased expression levels of IKK-β and intranuclear p65. Compared with the IR group, the expression level of IL-10 of serum and renal tissues in the sIPC group were increased.

CONCLUSIONS

sIPC exhibited a potent anti-inflammatory capacity to attenuated renal IR injury.

INCREASED TRAFFICKING OF MESENTERIC LYMPH-DERIVED γδ T CELLS INTO INTESTINAL MUCOSA IS ASSOCIATED WITH GUT INJURY AFTER INTESTINAL ISCHEMIA-REPERFUSION IN RATS

We sought to investigate the effects of mesenteric lymph-derived γδ T cells trafficking into intestinal mucosa on gut injury after intestinal ischemia-reperfusion (IIR). γδ T cells were separated from mesenteric lymph and then infused into the femoral vein of rats after the γδ T cells were labeled with 51Cr. Migration of γδ T cells in vivo across the intestinal mucosa was determined by γ-counter. Meanwhile, TNF-α activity and endotoxin concentration in mesenteric lymph were detected. The population of γδ T cells of Peyer's patches in the small intestines was analyzed by immunofluorescence double staining methods and flow cytometry. After IIR injury, the mean optical density value (MOD) and population of γδ T cells in Peyer's patches of the gut and migration of 51Cr-γδ T cells across the intestinal mucosa were significantly increased, which had highly positive correlations to degree of intestinal injury, TNF-α levels and endotoxin concentration in mesenteric lymph after reperfusion. The increased population of γδ T cells derived from mesenteric lymph trafficking into the intestinal mucosa might promote the small intestinal injury after IIR.

Observation of Electroweak Production of a Same-Sign W Boson Pair in Association with Two Jets in pp Collisions at sqrt[s]=13 TeV with the ATLAS Detector

This Letter presents the observation and measurement of electroweak production of a same-sign W boson pair in association with two jets using 36.1  fb^{-1} of proton-proton collision data recorded at a center-of-mass energy of sqrt[s]=13  TeV by the ATLAS detector at the Large Hadron Collider. The analysis is performed in the detector fiducial phase-space region, defined by the presence of two same-sign leptons, electron or muon, and at least two jets with a large invariant mass and rapidity difference. A total of 122 candidate events are observed for a background expectation of 69±7 events, corresponding to an observed signal significance of 6.5 standard deviations. The measured fiducial signal cross section is σ^{fid}=2.89_{-0.48}^{+0.51}(stat)_{-0.28}^{+0.29}(syst)  fb.